Saving the Youngest
THE shocking infant-mortality rate in the United States has caught the attention of the White House and Congress. How could it not, when the rate in Washington, D.C., approximates two deaths for every 100 children born - the worst record for any American city? The question is: Will the elected officials who did not blink at the expense of the Persian Gulf war and who mourned every fallen soldier appropriate annually the cost of one day of war - roughly $500 million - to help save those children's lives by providing basic prenatal care, nutritional guidance, and counseling to their mothers?
This is about the financial allotment that legislation being proposed by Sen. John H. Chafee (R) of Rhode Island would provide. His bill would make available $2.8 billion over five years to expand nationwide the services of community health centers that dispense elementary care. The White House has said only that in the next year it wants to spend $171 million to save babies in "10 cities with exceptionally high rates of infant mortality."
Already the debate over who gets what has begun, with 19 cities invited by the White House to compete by submitting plans for prenatal-care programs that must promise, on paper, to reduce infant mortality by 50 percent over a period of five years. Initially, members of Congress from rural areas asked why their constituents were not eligible for funds under the administration's cities-only plan when, for instance, a county in Mississippi has an infant mortality rate of three deaths per 100 births. The pl an now allows rural areas to apply.
This week Congress refused to allow the president to divert to his infant-mortality campaign money already allotted community health centers and other programs that serve low-income people. The administration had argued that the diversion of funds was necessary to get the infant-mortality effort launched in 1991, given the spending caps set by last fall's budget agreement, which demands that you take from one program if you're adding to another. Congress decided instead to appropriate an added $25 milli on for infant mortality this year.
Budgetary competition will test the country's commitment to lowering its infant-mortality rate. But if Americans cannot muster up the "troops," the funds, and a little of its technological and organizational ability to save many of the 40,000 American babies that die each year before their first birthday, what will it take to get our heartfelt attention in peacetime?